SEARCH · Search PubMed

Results for “ARCHIVES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 613 records · Page 34Linked to original sources

PubMed1994

Initial data-element selection for the evaluation of picture archiving and communication system performance.

The completely new, hospital-wide picture archiving and communication system (PACS) now being implemented at Osaka University Hospital is described elsewhere in this issue. This paper lists the many studies of the department and hospital that were performed before the PACS for the purpose of identifying data elements for use in evaluating a PACS system. A second purpose of the initial data-element collection was to assist in the overall Osaka University PACS design. Selected studies from this work are presented here.

Computer Systems↗

PubMed1997

Time and flow study results before and after installation of a hospital information system and radiology information system and before clinical use of a picture archiving and communication system.

The effectiveness of a hospital information system (HIS) and a radiological information system (RIS) was evaluated to optimize preparation for the planned full clinical operation of a picture archiving and communication system (PACS), which is now linked experimentally to the HIS and the RIS. One thousand IC (integrated circuit) cards were used for time studies and flow studies in the hospital. Measurements were performed on image examination order entry, image examination, reporting, and image delivery times. Even though after the HIS and the RIS operation only a small amount of time savings were realized in each time fraction component, such as in the patient movement time, examination time, and film delivery time, the total turn-around time was shortened markedly, by more than 23 hours on average. It was verified that the HIS and the RIS was beneficial in the outpatient clinics of the orthopedic department. Our method of measurement employing IC cards before and after HIS and RIS operations can be applied in other hospitals.

Computers↗

PubMed1997

Control method for preloading with priority information in an integrated radiology information system/picture archiving and communication system.

More than 10 years has passed since the concept of picture archiving and communication systems (PACS) was first proposed. A great deal of effort has been expended to make PACS suitable for routine use in clinical settings, but only a few systems are currently used in this manner. A major reason is the lack of the assurance of throughput equivalent to that of a conventional system based on order sheets and analog films. In this report, two techniques to increase throughput have been introduced and studied. The first is the preloading of data elements from the various information systems and the PACS. The second is the use of the priority information to rank order the examinations placed on the list for interpretation. We have applied these techniques to an actual system and have measured the distribution of time for processing examinations. These two techniques appear to make PACS useful in routine practice because most of the urgent cases were interpreted within the target time of 40 minutes.

Hospital Communication Systems↗

PubMed1997

The impact of a picture archiving and communication system on nuclear medicine examination interpretation.

Radiographic correlation is essential for many of the examinations performed in nuclear medicine. The purpose of this study was to evaluate the impact of a picture archiving and communications system (PACS) on the function and efficiency of a nuclear medicine department at a tertiary care institution. We evaluated 250 consecutive noncardiac nuclear medicine imaging examinations and asked the interpreting physician the following questions: (1) Was PACS used in the interpretation of the study? (2) Did the use of PACS expedite examination completion or aid in study interpretation? And (3) Did the use of PACS permit a definitive diagnosis to be made? PACS was accessed for correlative radiographic images in 155 of the 250 (62%) nuclear medicine examinations. Images available on PACS for review aided in study interpretation in 74% (115 of 155) of cases. The use of PACS was thought to expedite examination completion in 55% (86 of 155) of cases. The system was accessed but not operational in only 1% of cases (2 of 155). PACS provides reliable, rapid access to multimodality correlative radiographic images that aid in the interpretation of nuclear medicine examinations. Such systems also increase the efficiency of a nuclear medicine service by allowing timely and conclusive interpretations to be made.

Evaluation Studies as Topic↗

PubMed1996

Architectural design and tools to support the transparent access to hospital information systems, radiology information systems, and picture archiving and communication systems.

The fragmentation of the electronic patient record among hospital information systems (HIS), radiology information systems (RIS), and picture archiving and communication systems (PACS) makes the viewing of the complete medical patient record inconvenient. The purpose of this report is to describe the system architecture, development tools, and implementation issues related to providing transparent access to HIS, RIS, and PACS information. A client-mediator-server architecture was implemented to facilitate the gathering and visualization of electronic medical records from these independent heterogeneous information systems. The architecture features intelligent data access agents, run-time determination of data access strategies, and an active patient cache. The development and management of the agents were facilitated by data integration CASE (computer-assisted software engineering) tools. HIS, RIS, and PACS data access and translation agents were successfully developed. All pathology, radiology, medical, laboratory, admissions, and radiology reports for a patient are available for review from a single integrated workstation interface. A data caching system provides fast access to active patient data. New network architectures are evolving that support the integration of heterogeneous software subsystems. Commercial tools are available to assist in the integration procedure.

Computer Systems↗

PubMed1996

Large picture archiving and communication systems of the world--Part 1.

This is the report of a worldwide survey of 82 institutions done to identify large scale picture archiving and communication systems (PACS) in clinical operation in 1995. This survey found a continuing strong trend toward the creation and operation of large PACS. In the 15 months since the first such survey, the number of clinical large PACS went from 13 to 23, almost a doubling in that short interval. New systems were added in Asia, Europe, and North America. A strong move to primary interpretation from soft copy was identified, and filmless radiology has become a reality.

Follow-Up Studies↗

PubMed1996

Clinical application of the computer picture archiving and communicating system to stereotactic radiosurgery.

Stereotactic radiosurgery, a rapidly evolving technology, provides precise high-dose irradiation to brain lesions and tumors. A new method using digital subtraction angiographic images of a personal computer-image display terminal interfaced to our picture archiving and communication system (PACS) performs measurements and calculations of the coordinates of the location of the center of the lesion to be treated. The time required to calculate the coordinates was performed by three methods: hand calculation, digitizer method, and PACS method. These three coordinates were compared in 10 cases. The hand calculation method required approximately 50 minutes, the digitizer method required approximately 10 minutes, and the PACS method approximately 3 minutes. The difference is statistically significant (P < .001). The three methods were equally accurate. This type of PACS application using inexpensive personal computers interfaced more directly to a PACS is an emerging trend that facilitates wider access to images and to manipulating them for specialized applications.

Humans↗

PubMed1996

Experience and design recommendations for picture archiving and communication systems in the surgical setting.

An analysis of the efficacy of a picture archiving and communication system (PACS) in the surgical domain was undertaken at the Baltimore Veterans Affairs Medical Center. Interviews with surgeons and staff were conducted and supplemented by direct radiologist observation in the operating room (OR) and surgical outpatient clinic to determine patterns of routine clinical PACS use, levels of satisfaction both within and outside of the OR, and perceptions of the relative efficacy of the system in comparison to film. These data as well as suggestions from the surgical staff members were used to make recommendations for specific modifications in PACS design and operation to improve the current system and to help prescribe design improvements for future PAC systems. A high level of satisfaction with the system was found and the use of PACS was favored over film by a majority of surgeons and their staff. Findings of this study suggest that the design of a hospital-wide PAC system must have the flexibility to accommodate the specific requirements of a wide variety of end-users in their unique hospital environments.

Equipment Design↗

PubMed1996

Picture archiving and communication system training for physicians: lessons learned at the Baltimore VA Medical Center.

Physicians practicing at the "filmless" Baltimore VA Medical Center need to be proficient in the use of the picture archiving and communication system (PACS) to be able to view radiologic images and accompanying reports. PACS training is necessary to assure optimal patient care and to satisfy potential medicolegal requirements. Providing such training is the responsibility of both the Imaging Department and the hospital. Training in the use of the PACS at the Baltimore VA is conducted by an on-site application specialist. Data were collected from interviews with the trainer, training log sheets, and physician surveys. Although 100% of radiologists received formal training, only 22% of nonradiologists were formally trained; 32% of these physicians identified themsleves as having been trained by their peers and 41% stated they were self-trained. We identified two goals of a PACS training program. The first is to teach physicians how to retrieve images and reports from current as well as prior studies and display them on a computer workstation. Secondly, the training should include instruction on the use of the various workstation tools to enhance image interpretation. Imaging requirements and usage by different physician groups vary, and PACS training should be tailored accordingly. Difficulties in the scheduling of training sessions during working hours and the widespread use of a "generic" log-on identification have contributed to the low (22%) compliance of nonradiologists with the formal training program. Although we believe that one-on-one training is most effective and can be best tailored to the needs and computer expertise of an individual particular physician, computer based training (both on and off-line) may provide an acceptable, and in some cases, a preferred alternative.

Baltimore↗

PubMed1996

Clinical experience with a second-generation hospital-integrated picture archiving and communication system.

In a previous report we described a second-generation hospital-integrated picture archiving and communication system (HI-PACS) developed in-house. This HI-PACS had four unique features not found in other PAC systems. In this report, we will share some of our clinical experiences pertaining to these features during the past 12 months. We first describe the usage characteristics of two 2,000-line workstations (WSs), one in the in-patient and the second in the out-patient neuroradiology reading area. These two WSs can access neuro-images from 10 computed tomographic and magnetic resonance scanners located two medical centers through an asynchronous transfer mode network connection. The second unique feature of the system is an intensive care unit (ICU) server, which supports three WSs in the pediatric, medical surgery, and cardiac ICUs. The users' experiences and requests for refinement of the WSs are given. Another feature is physician desk-top access of PACS data. The HI-PACS provides a server connected to more than 100 Macintosh users for direct access of PACS data from their offices. The server's performance and user critiques are described. The last feature is a digital imaging and communication in medicine (DICOM) connection of the HI-PACS to a manufacturer's ultrasound PACS module. The authors then outline the interfacing process and summarize some of the difficulties encountered. Developing an in-house PACS has many advantages but also some drawbacks. Based on experience, the authors have formulated three axioms as a guide for in-house PACS development.

Computer Communication Networks↗

PubMed1999

Image processing strategies in picture archiving and communication systems.

An image processing strategy is presented that assures very similar soft-copy presentation on diagnostic workstations of a picture archiving and communication system (PACS) over the lifetime of an image file and simultaneously provides efficient work-flow. The strategy is based on rigid partitioning of image processing into application- and display-device-specific processing. Application-specific processing is optimized for a reference display system. A description of this system is attached to the file header of the application-specifically processed image which is stored in the PACS. Every diagnostic display system automatically reproduces the image quality for which the application-specific processing was optimized by adjusting its properties by display-system-specific processing so that the system becomes effectively equal to the reference display system.

Computer Systems↗

PubMed1999

Picture archiving and communication systems planning: a methodology.

This article presents the Picture Archiving and Communication Systems (PACS) planning methodology used by the Department of Defense's (DOD) Joint Imaging Technology Project Office (JITPO). This methodology evaluates four areas of PACS planning and implementation: strategic planning, clinical scenario planning, installation planning, and implementation planning. The first task is to develop a PACS team, from the local facility, that will execute the program. A written PACS plan is developed by the JITPO, with active input and final say from the site's PACS team. This plan includes the PACS goals and objectives, clinical requirements, facility requirements, and the status of the implementation. This methodology, when applied fully at a military clinical site, has resulted in the site obtaining best "value" in terms of cost and performance by requiring the DOD's contracted PACS vendors to propose a PACS package that meets or exceeds the site's unique requirements. The identification of the requirements and the matching of a known PACS configuration with them has reduced the number of unknowns within the vendors' proposals and created true competition in both initial cost and the cost to maintain PACS in the maintenance years. Although there are certain factors unique to planning a military PACS, such as preselected vendors, the planning methodology described in this article should provide a valuable strategy for any hospital planning a PACS.

Hospitals, Military↗

PubMed1997

Picture archive and communication systems implementation in a community medicine practice.

In order to gain experience with vendor-supplied picture archive and communication system (PACS) products, a Vantage PACS from Lockheed-Martin was installed in a Mayo community medicine practice in Rochester. This practice produces about 45,000 radiology examinations annually. The PACS includes central long- and short-term storage devices, 10 image display workstations, and a dedicated high-speed image distribution network. Digital images are produced using two Fuji computed radiography readers. Custom worklists were created to facilitate efficient system usage. Currently, all radiographic examinations for this practice are acquired digitally, and interpreted and distributed using the PACS. Remote softcopy interpretation via PACS has decreased the turnaround time for both routine and urgent examinations, and has allowed subspecialty interpretation or consultation for pediatric examinations. These results have significantly improved the radiology component of this community medicine practice.

Community Health Centers↗

PubMed1997

Highlights of the Digital Imaging Network-Picture Archiving and Communications System Project.

The Department of Defense issued its requirements for a Digital imaging Network-Picture Archiving and Communications System (DIN-PACS) in a Request for Proposals to industry in January, 1997. The DIN-PACS shall be an open systems network of digital devices designed for the effective acquisition, transmission, display and management of diagnostic imaging studies. This network is primarily based on two international standards, Digital imaging and Communications in Medicine (DICOM) and Health Level 7 (HL7). The DIN-PACS is required to communicate in a bidirectional manner with the Department of Defense standard hospital information system called the Composite Health Care System (CHCS) through an HL7 compliant interface. The DIN-PACS model and its published specifications stress functionality and performance rather than system architecture to allow industry to propose optimal approaches for implementation. This paper discusses the functional requirements of the DIN-PACS in terms of its internal operations as well as its communication with external systems and components. This is a US government work. There are no restrictions on its use.

Diagnostic Imaging↗

PubMed1997

Optimizing radiology in the new picture archiving and communication system environment.

Picture archiving and communications systems (PACS) have inescapably altered the face of radiology. Images are available to radiologists and clinicians alike, nearly instantaneously. For patient care management, service has improved, but without inclusion of input from radiologists. Effecting timely report availability requires reorganization of radiology. In a hospital-wide PACS environment, we undertook to render a preliminary report on all nonprocedural computed radiography examinations within 30 minutes in a teaching environment. Two periods of time in the same month were analyzed, one before reorganization and one after. Of 686 reports, 117 were examined with a statistical significance of alpha = .05 (95% confidence) and a power of 90%. Average times for examination acquisition to preliminary report availability on the PACS decreased from 5 hours to 31 minutes. Standard deviation in report generation times decreased from 8 hours to 30 minutes. This preliminary study suggests that business process reengineering can effect improvement in information flow within a teaching facility resulting in radiologists rejoining the patient care management team. Successes, pitfalls, and future requirements are discussed.

Efficiency, Organizational↗

PubMed1995

Quality assurance and quality control of an intensive care unit picture archiving and communication system.

Most radiology departments have established quality assurance (QA) and quality control (QC) programs for conventional film-based image management systems. At many institutions, digital image management systems, or picture archiving and communication systems (PACS), are replacing part or all of the film management system. In these situations, it is important to control the quality of the digital images that are produced. The observed frequency of eight types of image-related errors occurring on an image viewing station located in a medical intensive care unit is reported. Images on the viewing station were checked for 12 consecutive weeks. Film images available in the radiology reading room and digital images on the viewing station were compared with a list of completed examinations produced by the radiological information system. Overall, 1,082 patient examinations were encountered. Seventy-six images (7.02% of all images) were observed with errors. In addition, four previously unencountered types of errors were observed in 11 images (1.01% of all images). The majority of the errors are attributed to interfaces either between information systems or between the PACS and the user. It is concluded that QA-QC procedures are necessary for PACS, and that good interfaces, both between information systems and between humans and computer systems, are essential for successful PACS implementations.

Humans↗

PubMed1998

Does products liability litigation threaten picture archiving and communication systems and/or telemedicine?

Numerous writers have commented on barriers to the growth and progress of telemedicine. Among these barriers are reimbursement concerns, professional liability exposure, licensing restrictions, hospital credentialing questions, and other problems. A legal threat not generally described in the literature to date is the possibility that products liability claims could be brought against manufacturers and distributors of hardware, software, and peripherals used in providing telemedicine services. Several of these concerns extend to picture archiving and communication systems (PACS), including, of course, teleradiology. This article considers that possibility in the context of several potential plaintiffs' theories, discusses currently applicable law, and proposes approaches to diminishing the magnitude and severity of this potential threat.

Artificial Intelligence↗

PubMed1998

A comparison between digital images viewed on a picture archiving and communication system diagnostic workstation and on a PC-based remote viewing system by emergency physicians.

Picture Archiving and Communication Systems (PACS) make possible the viewing of radiographic images on computer workstations located where clinical care is delivered. By the nature of their work this feature is particularly useful for emergency physicians who view radiographic studies for information and use them to explain results to patients and their families. However, the high cost of PACS diagnostic workstations with fuller functionality places limits on the number of and therefore the accessibility to workstations in the emergency department. This study was undertaken to establish how well less expensive personal computer-based workstations would work to support these needs of emergency physicians. The study compared the outcome of observations by 5 emergency physicians on a series of radiographic studies containing subtle abnormalities displayed on both a PACS diagnostic workstation and on a PC-based workstation. The 73 digitized radiographic studies were randomly arranged on both types of workstation over four separate viewing sessions for each emergency physician. There was no statistical difference between a PACS diagnostic workstation and a PC-based workstation in this trial. The mean correct ratings were 59% on the PACS diagnostic workstations and 61% on the PC-based workstations. These findings also emphasize the need for prompt reporting by a radiologist.

Emergency Service, Hospital↗